| Violation Item
| Demerits
| Violation Description
| CDI | R | VR |
|
|---|
|
2
|
1
|
Floors clean, carpet clean, dry, odor free |
No |
No
|
No |
Keep all flooring clean. 15A NCAC 18A .1309 (a). Observed debris on flooring throughout. Observed debris on floors under resident's bed throughout. |
|
3
|
2
|
Walls and ceilings cleanable, clean, good repair |
No |
No
|
No |
Keep all walls and ceilings clean and in good repair. 15A NCAC 18A .1310. Observed crack in wall from ceiling to door jam and crack at door jam in room B36. Room A10 missing knob on door to toilet and debris on wall, food and other debris under bed. Loose railing on hall near toilet on A hall. Door need wider plate to completely cover hole from door knob. Laundry room has minor hole damage to wall. Touch up paint needed on wall throughout. Affix cover tightly on ceiling in room B36 toilet. Observed hole in the door in room B22. Replace face plate on cable outlet in room B43. PIC replaced face plate during inspection. Observed popcorn peeling and black residue from exhaust vent in beauty salon. |
|
8
|
2
|
Facilities conveniently located, clean and in good repair |
No |
No
|
No |
Keep all bathing equipment clean and in good repair. 15A NCAC 18A .1312 (a) and (f).
Keep all toilet equipment clean and in good repair. 15A NCAC 18A .1312 (b). Observed in room B36, dirty shower curtain and tub, trashcan propped under tank and between toilet catching and holding water and debris around the base of the toilet. In room B30, black residue (appear to be from mildew) in tub and debris around the base of the toilet. In B22 broken sink stop under sink. B43, dried urine under toilet seat and dirty shower. Loose toilet in women's toilet. Observed broken vaccum beaker on sink in maintenance room. REHS recommended to PIC to add a backflow prevention device to faucet. Observed full bucket of water propped under sink in beauty salon. |
|
11
|
2
|
Hand sinks used only for intended purpose |
No |
No
|
No |
Except for the stipulations stated in rule .1312 (d), handwashing sinks shall only be used for handwashing. 15A NCAC 18A .1312 (d). Residents clothing in hand sink in laundry room. PIC removed laundry out of sink. |
|
24
|
1.50
|
Vermine excluded |
No |
No
|
No |
Effective measures shall be taken to keep flies, rodents, cockroaches, and other vermin out of the establishment and to prevent their breeding or presence on the premises. 15A NCAC 18A .1317 (a). Observed roach coming out of box of diapers near the therapy room. |
|
32
|
1
|
Furniture clean and in good repair. Mattresses clean, dry, odor free |
No |
No
|
No |
All furniture, bed springs, mattresses, sleeping mats, draperies, curtains, shades, venetian blinds, or other furnishings in institutions shall be kept clean and in good repair. 15A NCAC 18A .1319 (a). Observed trash and debris under sofa and chair cushions in common area. Observed ripped pillows in rooms B36, B30, B22, and B43. Observed (maybe insect) droppings in drawers in empty room B47.
Repeat |
|
33
|
1
|
Linen changed when soiled. Soiled linen handled properly |
No |
No
|
No |
Clean bed linen in good repair shall be provided for each individual and shall be changed when soiled. 15A NCAC 18A .1319 (b). Observed food debris, dried drool on bed linen in room B30. |
|
34
|
1
|
Laundry area and equipment clean, linen disinfected, clean laundry stored and handled separately |
No |
No
|
No |
Clean linen shall be stored and handled in a separate room or area, or in another manner that will prevent contamination of clean linen. 15A NCAC 18A .1319 (b). Clean linen stored in hall near laundry room. Door block with dirty laundry at exit. |
|
35
|
1
|
Patient contact items in good repair, properly stored, cleaned and disinfected |
No |
No
|
No |
Patient contact items shall be kept clean and in good repair. 15A NCAC 18A .1319 (c). Observed ripped blanket on bed 2 in room A36 and food debris and stains on sheets on bed 1. Observed food debris and dried drool on bed 1 and soiled/dirty bedding on bed 2 in room B30. Observed dirty linen in drawer of empty room B47, blood stained pillow case and dirty linen and blanket in room B43. Observed bags of resident's clothing on floor in storage room. Observed diapers stored on the closet floor in room B43. Observed soiled pillow stuffed between bed and wall in room B30. Observed hair in chair and sink in beauty salon. Observed arms on wheel chair in common area ripped. |
|
43
|
1
|
Food storage units with thermometers, maintain temperatures |
No |
No
|
No |
All refrigerators shall have a thermometer and situated so that the thermometer can be easily read. 15A NCAC 18A .1323 (b). Observed no thermometer in refrigerator in room B43 and broken thermometer in refrigerator in therapy room. |